Claimed effect · NAD+ and precursors

Does NAD+ and precursors help with parkinson's disease progression?

B
Grade B — probable, not settled1 phase 3 RCT (NOPARK, n=410, 52 wk) · effect size: not measurable
Short answerProbable, not settled. Human data exist (1 phase 3 RCT (NOPARK, n=410, 52 wk)) and mostly agree, showing no measurable effect, or none yet shown — but too few, too small, or not yet peer-reviewed for a firm answer. NOPARK, published in JAMA on 8 October 2026: 410 people in Norway with Parkinson's disease diagnosed within the previous two years took nicotinamide riboside or placebo for 52 weeks on top of stable dopaminergic treatment. The total MDS-UPDRS score, where higher is worse, rose 2.45 points on nicotinamide riboside and fell 0.27 points on placebo: a difference of 2.72 points (95% CI 0.47–4.98, P = 0.02) in favour of placebo, about half the 5.2 points the abstract gives as a clinically important worsening. Non-motor symptoms also worsened more on the supplement; the three parts of the scale taken separately and dopamine-transporter imaging showed no significant difference. One phase 3 trial, so B; effect 0 because it found no benefit.

What the studies show

NOPARK, published in JAMA on 8 October 2026: 410 people in Norway with Parkinson's disease diagnosed within the previous two years took nicotinamide riboside or placebo for 52 weeks on top of stable dopaminergic treatment. The total MDS-UPDRS score, where higher is worse, rose 2.45 points on nicotinamide riboside and fell 0.27 points on placebo: a difference of 2.72 points (95% CI 0.47–4.98, P = 0.02) in favour of placebo, about half the 5.2 points the abstract gives as a clinically important worsening. Non-motor symptoms also worsened more on the supplement; the three parts of the scale taken separately and dopamine-transporter imaging showed no significant difference. One phase 3 trial, so B; effect 0 because it found no benefit.

“At week 52, the total MDS-UPDRS score increased by 2.45 (95% CI, 0.80-4.10) points with nicotinamide riboside and decreased by 0.27 (95% CI, -1.95 to 1.40) points with placebo, yielding an adjusted mean difference of 2.72 points (95% CI, 0.47-4.98 points; P = .02), favoring placebo.”

Verbatim, from the abstractBrakedal B, et al. Nicotinamide riboside for patients with early-stage Parkinson disease: the NOPARK randomized clinical trial. JAMA, 2026 (online 8 Oct)

Human trials exist and mostly agree, but there are too few of them, they are too small, or one big one is still reading out. Expect the grade to move.

  1. 1
    Brakedal B, et al. Nicotinamide riboside for patients with early-stage Parkinson disease: the NOPARK randomized clinical trial.JAMA, 2026 (online 8 Oct)410 randomised (206 nicotinamide riboside, 204 placebo), 393 in the primary analysis; 11 centres in Norway, 52 weeks. Adjusted difference in total MDS-UPDRS 2.72 points (95% CI 0.47–4.98) favouring placebo. NCT03568968.

In context

NAD+ is a coenzyme every cell uses for energy metabolism; it is not a peptide, but its precursors (NMN and NR) and intravenous NAD+ itself are sold across the same anti-ageing market. Randomised trials show the oral precursors reliably raise NAD+ levels and are well tolerated. What they have not shown is a clinical benefit: trials of metabolism, muscle and ageing are small, mixed and contested, and in a 410-person phase 3 trial, people with early Parkinson's disease scored slightly worse after a year on nicotinamide riboside than on placebo (JAMA, October 2026). Intravenous NAD+ has essentially no controlled evidence.

NAD+ and precursors is sold as supplement (nr/nmn); iv nad+ unlicensed. Legal status differs by country — see the regulation section or the jurisdiction pages.

Questions

Is NAD+ and precursors proven to help with parkinson's disease progression?
Not yet settled. 1 phase 3 RCT (NOPARK, n=410, 52 wk) — LYO grades it B, meaning probable but liable to change as trials read out.
What studies are behind the grade?
NOPARK, published in JAMA on 8 October 2026: 410 people in Norway with Parkinson's disease diagnosed within the previous two years took nicotinamide riboside or placebo for 52 weeks on top of stable dopaminergic treatment. The total MDS-UPDRS score, where higher is worse, rose 2.45 points on nicotinamide riboside and fell 0.27 points on placebo: a difference of 2.72 points (95% CI 0.47–4.98, P = 0.02) in favour of placebo, about half the 5.2 points the abstract gives as a clinically important worsening. Non-motor symptoms also worsened more on the supplement; the three parts of the scale taken separately and dopamine-transporter imaging showed no significant difference. One phase 3 trial, so B; effect 0 because it found no benefit.
Is NAD+ and precursors approved for this?
No. NAD+ and precursors is sold as supplement (NR/NMN); IV NAD+ unlicensed; it is not an approved medicine for any indication in the jurisdictions LYO covers.

Other outcomes for NAD+ and precursors

Written and maintained by LYO Research — how pages are written and checked. Reviewed 12 October 2026. Grades count human evidence only; see how LYO grades. Not medical advice. Correct this page →